Vascular Insufficiency (or Inadequate
circulation) may affect either the blood vessels moving blood away from the
heart (arteries) or the blood vessels returning blood back towards the heart
(veins).

Arterial
Insufficiencyis generally the more serious condition. This is
arterial blood carries oxygen and nutrients out to the bodies tissues. So
without blood flow, the body cannot function properly. Arterial
insufficiency can lead to pain with activity, pain with rest, infection,
gangrene, even death.

Diminished arterial circulation is seen
most commonly in smokers and diabetics and in the elderly.

Circulation can be tested
using a variety of specific testing methods. One simple tool
is a Doppler (pictured on the right). This sophisticated
machine is able to test blood flow in the arteries simply by placing
a probe on the skin, completely non-invasively.

A Photoplethysmograph (PPG)
uses a different sort of probe to test the smallest of blood vessels
known as capillaries--again painlessly.

Koven's SmartDop-20

Normal Doppler waveform.

We can also test blood flow
by assessing blood pressures at different levels (arm, ankle, toe,
e.g.) and doing comparisons in how the blood pressure varies at
different levels.

Diabetics, smokers, and the elderly may
need to have these tests performed as a screening measure. (The Achilles
Foot Health Centre is equipped to perform all these tests in our facility.)

Occasionally, other testing needs to be
performed. This additional testing may include, for example,
injecting dye into the blood vessels and doing special X-rays to look at the
arteries. This is typically done when simpler tests show diminished
circulation and we need to know the level of blockage in order to correct the
condition.

Diminished arterial circulation may be
treated with changes in lifestyle, medications, and surgery.

Venous
Insufficiency is generally less serious than
arterial insufficiency. Poor vein function means that the
blood tends to pool in the legs (swelling). This is frequently indicative
of poor valve function in the veins or certain conditions of the heart.

Vascular testing similar to that done
to test the arteries may be performed for the veins as well.

Treatment may include simple
compressive stockings to help push accumulating fluids up and out of the legs,
medications to help the patient excrete excess fluids, or surgery.